Aim. Comparative analysis of inhospital outcomes after open thrombectomy versus conservative in patients with acute lower limb artery thrombosis and coronavirus disease 2019 (COVID-19).Material and methods. In this retrospective, comparative study for the period from April 1, 2020 to December 1, 2021, 167 patients with acute lower limb artery thrombosis and COVID-19 were included. Depending on the treatment strategy, two following groups were formed: group 1  — open thrombectomy (n=136) + drug treatment (anticoagulant (unfractionated heparin) and antiplatelet (acetylsalicylic acid 125 mg 1 time per day) therapy; group 2  — only drug therapy (n=31). This group consisted of patients who refused surgical revascularization. In all cases, a psychiatrist examined for personality disorders that did not allow a critical assessment of their condition and the consequences of refusing surgical treatment. At admission to the hospital, all patients received prophylactic-dose unfractionated heparin (5000 IU 3 times/day). In the development of acute arterial thrombosis, 80 IU/kg (maximum 5000 IU) of unfractionated heparin was administered intravenously, followed by transfer to intravenous infusion at an initial rate of 18 IU/kg per hour with the partial thromboplastin time monitoring. Analgesic and antiplatelet therapy (acetylsalicylic acid 125 mg 1 time/day) was also prescribed.Results. Myocardial infarctions, ischemic strokes were not recorded. There were no significant intergroup differences in mortality rates (group 1: n=52, 38,2%; group 2: n=7, 22,6%; p=0,09; odds ratio (OR)=2,12; 95% confidence interval (CI): 0,85-5,27), limb amputation (group 1: n=63, 46,3%; group 2: n=9, 29,0%; p=0,07; OR=2,11; 95% CI: 0,9-4,91). However, there was a trend towards a decrease in the frequency of these events in the conservative therapy group. After open thrombectomy, retrombosis developed in 50,7% (n=69) of cases, whilethrombosis after retrombectomy followed by amputation  — in 46,3% (n=63). There were no hemorrhagic complications in both groups.Conclusion. Open thrombectomy with concomitant medical therapy and single conservative therapy without surgical revascularization in the present study showed comparable rates of death and lower limb amputations in patients with COVID-19.

Goal Presentation of the first Russian computer program ( www.carotidscore.ru ) for risk stratification of postoperative complications of carotid endarterectomy (CEE). Material and methods The present study is based on the analysis of a multicenter Russian database that includes 25,812 patients after CEE operated on from 01/01/2010 to 04/01/2022. The following types of CEE were implemented: 6814 classical CEE with plastic reconstruction of the reconstruction zone with a patch; 18,998 eversion CEE. Results In the hospital postoperative period, 0.18% developed a lethal outcome, 0.14%—myocardial infarction, 0.35%—stroke. The combined endpoint was 0.68%. For each factor present in patients, a predictive coefficient was calculated. The prognostic coefficient was a numerical indicator reflecting the strength of the influence of each factor on the development of postoperative complications. Based on this formula, predictive coefficients were calculated for each factor present in patients in our study. The total contribution of these factors was reflected in “%” and denoted the risk of postoperative complications with a minimum value of 0% and a maximum of 100%. On the basis of the obtained calculations, a computer program CarotidSCORE was created. Its graphical interface is based on the QT framework ( https://www.qt.io ), which has established itself as one of the best solutions for desktop applications. It is possible not only to calculate the probability of developing a complication, but also to save all data about the patient in JSON format (for the patient’s personal card and his anamnesis). The CarotidSCORE program contains 47 patient parameters, including clinical-demographic, anamnestic and angiographic characteristics. It allows you to choose one of the four types of CEE, which will provide an accurate stratification of the risk of complications for each of them in person. Conclusion CarotidSCORE ( www.carotidscore.ru ) is able to determine the likelihood of postoperative complications in patients undergoing CEE.